We are now at the Middle of the End. Medicare now has this bounty hunter system using "recovery audit contractors", where auditors look for "overpayments" and errors. There has been criticism, though, about inconsistent methods and a lack of oversight of the auditors.
But for physicians who come under the gaze of the contractors, the costs to the practice can be far more than the Medicare money at stake.I suspect that this is part of Medicare's death by a thousand cuts. The hassle factor for dealing with Medicare will exponentially increase to the point that few participating providers will be left standing.
Marilou Terpenning, MD, a hematologist-oncologist in Santa Monica, Calif., had to respond to several rounds of medical record requests from PRG Schultz for claims involving alleged overpayment for chemotherapy. Some of the cited overpayments were as little as $13 or so per claim, but the cost to the practice of retrieving the corresponding record and forwarding the information could be 10 times that amount, she said.
(It was raining all morning, so I decided to write a relevant post :-)